NPI | 1083723340 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: SD 1205) |
Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: SD 1205) |
Enumeration Date | 2006-08-30 |
Last Update Date | 2007-10-17 |